Healthcare Provider Details

I. General information

NPI: 1285029074
Provider Name (Legal Business Name): KEVIN JUSTIN MILLS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1469 8TH AVE
BETHLEHEM PA
18018-2256
US

IV. Provider business mailing address

1469 8TH AVE
BETHLEHEM PA
18018-2256
US

V. Phone/Fax

Practice location:
  • Phone: 484-658-5758
  • Fax: 833-213-6428
Mailing address:
  • Phone: 484-658-5758
  • Fax: 833-213-6428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD472708
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: